Free Asthma Essay Sample
Asthma is a common occurrence in children and adults of all ages. Chronic airway inflammation is a common characteristic of asthma that significantly influences diagnosis, disease management, as well as prevention. Advanced practice nurses engage in the treatment of asthma to prevent the development of asthma exacerbations, which can induce life-threatening complications. Advanced practice nurses also provide treatment of patient with asthma depending on the severity of their symptoms. With this in mind, they need to understand the severity of the symptoms and participate in the identification of triggers. The identification of triggers allows advanced practice nurses to recommend the best asthma management approaches for improved patient outcomes. Further, understanding patient factors and stepwise approach can provide for effective management of the disease. The paper explores the treatment options available for asthma patients and stepwise treatment and management of the disease, including the various ways stepwise management helps advanced practice nurses achieve better disease control.
A stepwise approach to asthma in the form of pharmacological therapy allows advanced practice nurses to minimize the risk of impairment and asthma exacerbations. The stepwise use of pharmacologic therapy also reduces the likelihood of hospitalization and emergency department visits. Holt (2009) noted that a SABA is a suitable treatment option for quick relief of asthma symptoms. The SABA treatment option may entail the use of pirbuterol, albuterol, and levalbuterol. A SABA is the right treatment option for patients who have intermittent asthma. Treatment with SABA allows for the revitalization of pulmonary function and relieves the uncommon symptoms associated with intermittent asthma. Long-term control of asthma requires the use of long-term medications often recommended when dealing with patients with persistent asthma. The long-term control medication consists of drugs with anti-inflammatory effects. The use of ICSs is recommended for the initiation of long-term control drug therapy and assists in the management of persistent asthma.
The first step in the management of asthma involves the use of SABA. The initiation of SABA therapy is adequate for dealing with intermittent asthma. The management of intermittent asthma with SABA allows for the advanced practice nurse to deal with infrequent symptoms. It is often utilized on an as-needed basis. The use of SABA as a quick-relief treatment option for over two days in a single week implies that an advanced practice nurse should pursue treatment for persistent asthma unless SABA is used in managing viral infection exacerbations. SABA may be appropriate for the management of mild symptoms of asthma in patients with exacerbations attributable to viral respiratory infections.
The second step in the management of asthma involves the use of long-term control medication. The most suitable recommended treatment entails the use of low dosages of ICS on a daily basis. However, an advanced practice nurse can make use of sustained-release theophylline, cromolyn, nedocromil, and LTRA as alternative treatment options when dealing with mild persistent asthma. However, the aforementioned alternative treatments do not qualify as the preferred treatment options. Even so, nedocromil and cromolyn exhibit some degree of efficacy. LTRAs facilitate the prevention of asthma symptoms and the long-term disease management. Although advanced practice nurses can opt to use sustained-release theophylline as an alternative treatment, it is associated with moderate clinical effectiveness. It serves as an anti-inflammatory medication and a bronchodilator.
Step three care for asthmatic patients requires making the necessary consultations to develop the most appropriate therapeutic option. It is recommended that advanced practice nurses take into account the risks and benefits of various treatment options, including inhaler technique, allergens, therapy adherence, and comorbid conditions. It is recommended that a LABA is added to the drug therapy involving the use of low-dose ICS. The inclusion of a LABA more preferably formoterol or salmeterorl facilitates the control or management of asthma that is still not controllable using low or medium ICS dosage. A LABA assists in improving lung function, minimizes cases of exacerbations and reduces asthma symptoms. However, a health practitioner can resort to the use of ICS alone, but this requires raising the ICS dosage to the medium range. Even so, the effectiveness of this treatment option is limited. The inclusion of a LABA in the drug therapy decreases the occurrence of exacerbations and minimizes chances of impairment as opposed to increasing ICS dosage. In step three case, alternative therapy includes the addition of zileuton, an LTRA, or even a theophylline to the low dosages of ICS. It only recommended when patients show adverse effects to LABA or cannot respond to LABA. The alternative treatments show moderate clinical effectiveness when it comes to improving lung function and controlling asthma.
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Step four care involves raising ICS dosage to the medium range and at the same time adding a LABA. It is appropriate for controlling asthma that is not adequately controlled with the step three treatment option. It is recommended for patients who suffer severe exacerbations leading to hospitalization or emergency department visit. The treatment option minimizes recurrent mild to severe exacerbations. The alternative treatment option at this level involves the use of a medium dosage of ICS with a drug such as zileuton, LTRA, or theophylline.
The step five care requires the adoption of a high dose of ICS together with a LABA. A health practitioner can provide patients who exhibit sensitivity to specific perennial allergens with omalizumab. Such patients must undergo monitoring for anaphylaxis or any changes after receiving omalizumab. Step six involves the addition of oral corticosteroids to the drug therapy adopted in step five. The inclusion corticosteroid allows for the management of asthmatic patients whose disease is not adequately controlled using drug therapy in step five. Corticosteroids decrease airway hyperresponsiveness and facilitate long-term control of severe persistent asthma (Asthma Initiative of Michigan, n.d.). According to Asthma Health Center (2015), corticosteroids control airway inflammation and decrease the quantity of mucus produced in the bronchial tubes. As such, stepwise management allows health care practitioners and patients to control the disease more effectively depending on medication response and disease severity.
In conclusion, asthma control is very important because it reduces impairment and life-threatening exacerbations. Advanced practice nurses should provide treatment based on the severity of the condition. The treatment options range from quick relief to long-term control of the condition and require a clinician to consider the best therapy for better patient outcomes.